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24 Cards in this Set

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Name the functional divisions of the frontal lobes
(See image)
What is "the most common presenting problem in neuropsychology"?
Executive deficits.
(Ann. Rev of Psych 53:401-33)
As an alternative to proliferating terminology, such as "executive functioning", "dyexecutive syndrome", "frontal lobe functions", some authors focus on __________________.
Specific "anatomical/behavior functional relationships"
(Ann. Rev of Psych 53:401-33)
One anatomical distinction which is consistent in the literature is between ______ and _______ of the frontal lobes, corresponding roughly to affective and cognitive processes, respectively
ventral regions ("lower/base" processes) and dorsal regions ("upper/cognitive" processes)
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
The frontal lobes, in particular the ______ ______, are involved in uniquely human activities including self-awareness and "mental time-travel"
frontal poles
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
____________ dysfunction is the most common presenting problem in neuropsychological practice.
executive
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
True or False: Few frontal measures adequately reflect current empirical work.
True. By contrast, memory, language, etc measures do incorporate such information.
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
Define "behavioral neurology".
Assumes that certain aspects of behavior, and even some complex behaviors, are relatively hardwired into the adult nervous system.
Implies also that damage to a specific area of the brain will result in "a certain kind" of functional deficit.
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
The DLPFC is part of an archicortical trend originating in the ___________ (structure name)
Hippocampus
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
True of false: Most of what is known about (pre)frontal functions in neuropsychological studies is based on patients with DLPFC dysfunction.
True.
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
The VLPFC is part of a paleocortical trend emerging from the ________ cortex.
olfactory (caudal orbital-prefrontal). So smell and emotions are evolutionarily linked from the very beginning.
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
The ______ and the __________ frontal regions are associated with inhibition, emotion, reward-processing, punishment, drive. All of which suggests a central role in _____________ ____________. Yet these areas are poorly addressed in standard neuropsych batteries (see also Len Kozoil's lecture on basal ganglia)
the VENTRALMEDIAL and the ORBITAL FRONTAL regions... associated with BEHAVIORAL SELF-REGULATION. (See diagram for locations--ventral medial includes inner and bottom portions of cortex).
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
Superior medial frontal lesions are associated with the ____________ syndrome--that is, lack of ____________. In this sense, it can sometimes "mimic the lateral regions".
Apathetic syndrome. Lack of initiation.
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
True of False: A major problem of standard "frontal" tests is that they were often developed on the basis of face-validity (although some emerged from lesion research). What is needed is theory-driven measures.
True.
From: Lessons from Studies of the Frontal Lobes; Stus and Levine (Ann Review Psych, 2002. 53:401
Excluding motor problems (articulation) and Broca's aphasia, FRONTAL influence on language problems can be divided into two types: ________ and ________.
ACTIVATION problems in speech output, and FORMULATION/paralinguistic problems.
Lessions from Studies of the Frontal Lobes, Stus & Levine; Ann Rev Psych 2002:53:409
Frontal "activation" language difficulties with speech output can be tested with ____________________.
Phonetic fluency (FAS) and semantic fluency ("Animals"). Based on 74 patients, Stus & Levine found nearly complete separation between left versus right DLPFC for FAS. In addition, BILATERAL superior medial frontal were affected in impaired FAS, and also left parietal (note association with language / reading/praxis). Imaging studies suggest, in addition, posterior *temporal* region.

NOTE THAT "ANIMALS" WAS IMPAIRED IN ALL REGIONS EXCEPT RIGHT PARIETAL! SO NOT VERY SPECIFIC, ALTHOUGH ALSO IMPAIRED IN ACTIVATION PROBLEMS.
Lessions from Studies of the Frontal Lobes, Stus & Levine; Ann Rev Psych 2002:53:409
What brain regions were found to be impaired when FAS was defective (Stus & Levine study of lesioned patients).
1) LEFT DLPFC (e.g., similar to Broca's aphasia, dynamic aphasia, and transcortical aphasia).
2) BILATERAL superior medial frontal (consistent with "apathetic" syndrome).
3) LEFT parietal (consistent with language association).

In summary: Left DLPFC and left parietal (language component), and bilateral superior medial (drive and motivation component).

Note that imaging studies also suggest left superior temporal (close to left parietal), in addition to left DLPFC, left cortex, and bilateral superior medial.
Lessions from Studies of the Frontal Lobes, Stus & Levine; Ann Rev Psych 2002:53:409
What areas are impaired with SEMANTIC fluency tests (e.g., Animals).
All lobes except right pariental. Thus, semantic fluency is sensitive but not specific to "activation" language problems.
Lessions from Studies of the Frontal Lobes, Stus & Levine; Ann Rev Psych 2002:53:409
What two frontally-related language disorders are classified as "activation" deficits (Stus & Levine)
DYNAMIC APHASIA (medial frontal--i.e., anterior cingulate, SMA) and TRANSCORTICAL APHASIA (left DLPF superior-anterior to Brocas).
Lessions from Studies of the Frontal Lobes, Stus & Levine; Ann Rev Psych 2002:53:409
"Formulation" problems in frontal-language impairment (sentence, narrative deficits) reflect general difficulties in _____________. For example, dynamic aphasia or transcortical aphasia.
Planning (syntactical) and goal-attainment. Note that Stus and Levine differ from Luria's description of dynamic aphasia. Luris described dynamic aphasia as "the planning aspect of language". Yet Stus and Levine place dynamic aphasia in the "activiation" deficit category rather than formulation.
At the level of sentence generation/complex syntax, "formulation" problems are are always associated with lesions in the ______ cortex.
left
At the level of narrative (organization of sentences), *narrative* formulation problems are of two general types, each associated with a different frontal area:
(1) simplification/loss of details (persevation, and omission of sentences), left DLPFC.
(2) Amplification of details but loss of overall story structure, right DLPFC (like RCFT!). Causes wandering from subject to subject, dysprosody, insertion of irrelevant details, dysprosody.
Left DLPFC damage is associated with what kind of "narrative" deficits?
Loss of details (as in RCFT), simplification, omissions. Think also of the simplifications of speech in Brocas, although Broca's is slightly outside of the DLPFC and is more ventrolateral PFC.
Right frontal deficits are associated with what kind of "narrative" deficits?
Amplification of details but loss of story structure/"shape" (analogous to rt frontal effects on RCFT). In addition, wandering from topic, dysprosody, insertion of irrelevant details. In sum, incoherent narrative.